AS03 (for "Adjuvant System 03") is the trade name for a squalene-based immunologic adjuvant used in various vaccine products by GlaxoSmithKline (GSK). It is used, for example, in GSK's A/H1N1 pandemic flu vaccine Pandemrix. Also in Arepannix and the new Q-pan for H5Ni influenza.
A dose of AS03 adjuvant contains
AS03 is cited as the "likely cause" of dozens of acute narcolepsy cases in Finland.
There was increased risk of anaphylaxis following administration of 2009 AS03-adjuvanted monovalent pandemic A/H1N1 vaccine. Anaphylaxis after trivalent influenza vaccination is typically reported at a rate of <1 per million doses. In Quebec, Canada, anaphylaxis following administration of the monovalent AS03-adjuvanted H1N1pdm09 vaccine was reported through passive surveillance at a rate of 8 per million doses administered. This was 20 times higher than the reporting rate for non-adjuvanted trivalent vaccines administered during the six previous seasons. However, adequate estimation of the incidence of anaphylaxis is hindered by wide variations in definitions and diagnosis. Summary of paper: • Quebec passive surveillance showed an increase in anaphylaxis after H1N1pdm09 vaccination. • Many cases which were reported as other AEFI also met the criteria for anaphylaxis. • Anaphylaxis was likely underrecognized and its incidence higher than passively observed. • Incidence of anaphylaxis is estimated at 13 per million doses administered. • Enhanced public awareness is unlikely to be the predominant explanation for this increase. 
- "FDA panel endorses H5N1 vaccine with adjuvant". 15 Nov 2012.
- Pandemrix – Summary of product characteristics, European Medicines Agency websiteEuropean Medicines Agency website
- AL: Narkolepsiaa aiheuttaneen rokotteen olisi voinut korvata
- Increased risk of anaphylaxis following administration of 2009 AS03-adjuvanted monovalent pandemic A/H1N1 (H1N1pdm09) vaccine Vaccine 19 Oct 2013 Online
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